This invention relates to a novel well leg support for an orthopedic procedure. More specifically, this invention relates to a well leg aperture support for an arthroscopic examination and/or surgery.
An arthroscope is an instrument that permits an orthopedist to visually examine the interior of a patient's joint. Initially arthroscopy was utilized by orthopedists as an examination tool to explore a potentially damaged knee joint. More recently the procedure has been extended to examination of other joints of the body and significantly has evolved into a very successful use during operative procedures.
One of the first arthroscopic surgical procedures involved the resection of a small necrotizinganthomatous giant cell tumor in the suprapataller recess. Following initial successes, and refinement of surgical techniques and equipment, operative arthroscopic procedures have included chondral shaving, joint debridgement, abrasion chondroplasty, lateral retinacular release and synovectomy. In the more recent past, combined procedures have been successfully performed wherein operative arthroscopy and independent incision of a knee have been combined to perform meniscal repair and ligament reconstruction.
Over the past three decades, arthroscopic techniques have evolved to the point that arthroscopy is one of the most common, surgical procedures performed by orthopedists. Particularly with respect to the more recent techniques; however, near--total circumferential access to an operative knee is required. Accordingly, it is necessary to abduct the well leg to permit unencumbered access to the joint of surgical interest.
In the past, the well leg has been allowed to drape over the end of an operating table by gravity and was held in position with elastic binding to a retaining member on the side of an operating table. Although expedient, this technique, particularly for an extended operative procedure, tended to induce hyperextension of the hip and/or lumbar region of the spine which created a potential for a femoral nerve traction injury, impaired venous outflow from the leg, pressure on the peroneal nerve below the knee and as a minimum postoperative soreness and patient discomfort.
The above noted technique of expediently isolating a well leg was improved by the use of a well leg knee support sculptured from foam rubber or a Silastic pad. These devices were designed to be positioned upon an operating table beneath a well knee to raise and abduct the well leg. Although the provision of a padded support was an enhancement with respect to dangling abduction, it is possible, particularly with respect to extended procedures for the peroneal nerve to be compressed tending to induce temporary paralysis in the non-operative limb following surgery. Still further, it is possible to encounter venous thrombosis resulting in vein occlusion and possible pulmonary emboli or clots to the lung.
The difficulties suggested in the proceeding are not intended to be exhaustive but rather are among many which may tend to reduce the effectiveness and physician satisfaction with prior well leg abduction techniques during arthroscopic examination and/or surgery. Other noteworthy problems may also exist; however, those presented above should be sufficient to demonstrate that well leg supports appearing in the past will admit to worthwhile improvement.